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Certificates of Insurance NrlfMlnsurance !J Group NEW JERSEY CASUALTY INSURANCE COMPANY 301 Sullivan Way, West Trenton, NJ 08628 609-883-1300 CERTIFICATE OF WORKERS COMPENSATION INSURANCE RECEIVED INSURED APR 1 9 2006 AIS RISK CONSULTANTS INC 4400 HIGHWAY 9 STE 1000 FREEHOLD NJ 07728 111...1...11...1..1.11..1....11..11.1..1...11..1.1.11....11..1 MONROE COUN'fY RISK MANAGEMENT PROJECT OPERATIONS IN THE STATE OF NEW JERSEY POLICY NO. M/23872-5-05 EFFECTIVE 09/14/2005 EXPIRING 09/14/2006 This policy insures the obligations imposed upon the Insured by the provisions of the Workers Compensation Law of New Jersey. The limits of liability for Part Two - Employers Liability - under this policy are as follows: Bodily Injury by Accident $500,000 each accident, and for Bodily Injury by Disease $500,000 policy limit, $500,000 each employee. NOTE: Waiver of subrogation and/or inclusion of interests not owned in the majority by the insured are not permitted under this policy by New Jersey Workers Compensation Statute. WITH RESPECT TO THE NEW JERSEY COMPENSATION LAW, COVERAGE EXTENDS TO NEW JERSEY EMPLOYEES EMANATING FROM THE STATE OF NEW JERSEY. 'f'{) .~ t..f - d5- 06 '(... The issuance of this Certificate imposes no liability on the Company beyond that provided by the terms, conditions and exclusions of such policy as are described above by policy number, effective and expiration dates. CERTIFICATE HOLDER BROKER ~(L MONROE COUNTY A POLITICAL SUB DIV OF THE ST OF FLORIDA 1100 SIMONTON ST KEY WEST FL 33040 I.." ...11,11.,..1.," 1"",11.."11,,," 11,..11." 11....1.1.1 RUCHMAN ASSOC INC 21 MORRIS AVE PO BOX 106 ROCKVILLE CTR NY 11571 04/11/2006 ACORD.. CERTIFICATE OF LIABILITY INSURANCE OPJD.M DATE IIIMIDDIY'NYI AZSlU-l 04/11/06 PRODUCER THIS CI!RTl'lCATI! 18 ISSUED A8 A MATTER OF INFORMAOON ONLY AND CONf'I!RS NO RIGHTS UPON THE CERTIfICATE Selective SeJ:Vic:. Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 13325 ALTER THE COVERAGE Aff~DED BY THE POLICIES BELOW. P.ic:llIaon4 n 2322S-0325 Phone: 877-744-3125 INSURERS Al'F~DING COVERAGE HAle 11 INSIJRED INR~EP A S.lecU.. .~ I&w....~ Co. 26301 INS ~EP B tig Risk Consultants Xnc It/5'.lPEP ( -~..---- -------..-.. .. ~ 4 0 llt 9 south IN::.1l1;I.'L;' Freehold NJ 07728 IN:....REPE COVERAGES _ POLICIES r:F iIlSLI'lAtCE LISTED BELOW HAVE BEEN ,ssuec TO 1l<E INSU'lED.......eo ABOVE F '" '>t< p,:OLley PERtOO INDIi:ATED NO'lWI1HSTANC>INI; MY REr.l..llREro.ENT. TEFaIt OR CCHJITION OF NfY CQNrRPoCT ooonER [)()l';I.HENT 'NI-HRE~E:Cl 1"_, V\'Hl~11 IHIS CERlIFICA'~)MY tiE; ISSlE.D on VA. ~TA"'. Tt<E ...SUWlCE PFF~ 8Y T>E POliCIES CESCRI8EO HEREIN IS SOJIlJECT TO "I-L n-. TPMS. EXClUSIONS MC> CON)fTI()NS r:F SUCH pouCIFS >.GGRf'GATE lIo.l1TSSHQWIoj IMY HAil!: BEEN REOOCro BY PAID ClAIMS LTR NiiRil m>E Of ~ i GEHERAL LIAIILITY ~ X, :~:0MlIER<:~ GEtERAL UAflILIT( .-- m 1 (LA'MS WIDE D OCCuR A . X Busilless OWners o.-J ~ ~EJtL .AI...~REG.ATE UMrT .APPlIES PER f'OlIC'f X ~ LOC , AUTOMOilU UAIIL/TY ---, l_-l ,l,j\h AUTO A:..l O'J"mE.D AUTOS SCHEDULED AUTOS X h1RFO AI/TQS I X NON-OWNED AUTOS I 1000000 I 100000 I 5000 I I 3000000 I 3000000 "OUCY~ DATE /MINDOIYVI LIWTS S 1710198 EACH OCCURRENCE l~~.I~?i~.t~!_~~~'!l. . !rEO 8<J' 1At'rf ont WSM) 08/20/06 08/20/05 !>ERSOMl4 IoDV INJURY GENERAl. AGGIlEGATE PROOuCTS . C<::INP/OP AGG I Co;.elNED SINGlE LIMIT IF,. "",-'cieri) ---------.. ~~._-_..- I BODll'( INJLR'i 1 lP.r ~.,",onl I 800IL Y !N..URY lPljr acCI<Mt) PRoPERTY OIlW.GE (Pet accldaf1fl GARAGE llAlllLl1'Y .~\1\ PlJTO COIl. Y - EA ACCICENl .1'\N'rIWTO OTHER THAN AUTO OK Y IOAAC( I p;:;l; EXce"IUMIlllEI.l.A LWlLIlV =:J OCC'-'l 0 CLAIMS MADE F ACH OCCUlllENCf AGGPEGATE iCE.hJ(:r.aE. RETENTlet.I I WORKERS COW'ENSA11ON AND BFt.OYERlr L~1lY' ~J)' PR':)PRIETORJPAATNERlEXECUTtVE .:rriCrh'n.CtlEER CXClLClFO' ~p[~I~~~t=-NS bebY OTHER E L DISEASE POlICV llr.4,tT PROPEllTY 26590 DESCRPTION Of IlOCATlONS f V&lC\.ES f iXCLUSlOtlS ~ IV l!NlOIISl!IoENT I SPECIAl. I'RO\llSlONS The certitiea~e holder is named as additional insured. CERTIFICATE HOLDER CANCELLATION SHOULD ~ Of lIE AllO'" 0E1aIIlEO 1'OLIC1iS. CAtlCIilLED BEfORE lIE EXI'IIlA 110N DATE THEREOr'. lIE IlSUING INllUIlER WU ENDEAVOR TO.....l 30 DAn-.rT&N NOTICE TO lIE CERT1F1CATE HOlDER NAMED TO THE LEFT. BUT FAIlURE TO 00 SO SH"'L ..OlE NO 0llUClA'IlON OR UAIlUTY C# IH< KIND lJI'ON 1HE INSURER. ITS AGENTS OR REPRE~A1M8. Monroe County; POlitical Subdivision ot Florida 1100 Simonton Street Key Hest n. 33040 ACORD 25 (2001/08) o ACORD CORPORATION 1988 NrlrMInsurance ~, Group NEW JERSEY CAsuALlY INSURANCE CoMPANY 301 Sullivan Way, West Trenton, NJ 08628 609-883-1300 CERTIFICATE OF WORKERS COMPENSATION INSURANCE INSURED AIS RISK CONSULTANTS INC 4400 HIGHWAY 9 STE 1000 FREEHOLD NJ 07728 111...1...11...1..1.11..1..11111111.1..1...11111.1.11....11..1 PROJECT NJ EMPLOYEES EMANATING FROM NJ TO DO WORK IN THE ST OF FL POLICY NO. M/23872-5 EFFECTIVE 09/14/2008 EXPIRING 09/14/2009 This policy insures the obligations imposed upon the Insured by the provisions of the Workers Compensation Law of New Jersey. The limits of liability for Part Two - Employers Liability - under this policy are as follows: Bodily Injury by Accident $500,000 each accident, and for Bodily Injury by Disease $500,000 policy limit, $500,000 each employee. NOTE: Waiver of subrogation and/or inclusion of interests not owned in the majority by the insured are not permitted under this policy by New Jersey Workers Compensation Statute. WITH RESPECT TO THE NEW JERSEY COMPENSATION LAW, COVERAGE EXTENDS TO NEW JERSEY EMPLOYEES EMANATING FROM THE STATE OF NEW JERSEY. ...~'~C1 The issuance of this Certificate imposes no liability on the Company beyond that provided by the terms, conditions and exclusions of such policy as are described above by policy number, effective and expiration dates. a.- CERTIFICATE HOLDER BROKER MONROE COUNTY A POLITICAL SUB DIV OF THE ST OF FLORIDA 1100 SIMONTON ST KEY WEST FL 33040 1..11...11.11....1..111.....11..111111.1111...11...11....1.1.1 RUCHMAN ASSOC INC 21 MORRIS AVE PO BOX 106 ROCKVILLE CTR NY 11571 08/24/2009 ACORD. CERTIFICA TE OF LIABILITY INSURANCE OP 10 AL I DATE (MM/DDNYYY) AISRI-1 08/24/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Selective Service Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. o. Box 13325 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Richmond VA 23225-0325 Phone: 877-744-3125 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A Selective Way Insurance Co. 26301 INSURER B AIS Risk Consultants Inc INSURER C 4400 Rt 9 South INSURER D Freehold NJ 07728 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS IN:st< ~~~ POLICY NUMBER I"D~~{MM/DDNY)<;; P:5kt1:) (MM/DDNY) LIMITS LTR TYPE OF INSURANCE GENERAL LIABILITY EACH OCCURRENCE $ 1000000 - UAIVV-\\;>C I V KCI\l1 CU A COMMERCIAL GENERAL LIABILITY S 1710198 08/20/09 08/20/10 PREMISES (Ea occurence) $ I CLAIMS MADE D OCCUR MED EXP (Anyone person) $ 10000 X Business owners PERSONAL & PDV INJURY $ Incl - GENERAL AGGREGATE $ 3000000 - GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 3000000 I n PRO- rxl LOC POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - $ ANY AUTO (Ea aCCIdent) - ALL OWNED AUTOS BODIL Y INJURY - $ SCHEDULED AUTOS (Per person) - X HIRED AUTOS BODIL Y INJURY ~ $ X NON-OWNED AUTOS (Per accident) ~ - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ~ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ -- EXCESSIUMBRELLA LIABILITY -~ \ ~, EACH OCCURRENCE $ ~ OCCUR D CLAIMS MADE AGGREGATE $ -, $ ~ DEDUCTIBLE $ RETENTION $ ( $ .. WORKERS COMPENSATION AND '{ I we STATU- I IV~~- TORY LIMITS EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE EL EACH ACCIDENT $ OFF ICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ If yes, descnbe under SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is included as additional insured as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Monroe County PO Box 1026 Key West FL 33041 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. A RI PRES ACORD 25 (2001/08) @ACORD CORPORATION 1988